Autism_ Epilepsy _ Seizures

Document Sample
Autism_ Epilepsy _ Seizures Powered By Docstoc
					Is an Emergency Room Visit Needed?
An uncomplicated convulsive seizure in someone who has
                                                                      For Law Enforcement Officers:
                                                                      Epilepsy And Drugs
                                                                                                                                   Could It Be Epilepsy?
                                                                                                                                                                                               Autism, Epilepsy
Epilepsy is not a medical emergency, even though it looks
like one. It stops naturally after a few minutes without ill
effects. The average person is able to continue about his
                                                                      Despite medical progress, Epilepsy cannot be cured in
                                                                      the same sense that an infection can be cured. However,
                                                                                                                                   Only a physician can say for certain whether or not
                                                                                                                                   a person has Epilepsy. Many people miss the more
                                                                                                                                   subtle signs of the condition and therefore also miss
                                                                                                                                                                                                    & Seizures:
business after a rest period, and may need only limited               seizures can be controlled completely or significantly
                                                                                                                                   the opportunity for early diagnosis and treatment. The         How to Recognize the Signs and
                                                                                                                                   symptoms listed below are not necessarily indicators of
assistance, or no assistance at all, in getting home.                 reduced in most people who have the disorder. This
                                                                                                                                   Epilepsy, and may be caused by some other, unrelated              Basic First Aid When You Do
However, occasionally a seizure will fail to stop naturally           control is achieved through regular, daily use of
                                                                                                                                   condition. However, if one or more is present, a
and as noted earlier, there are several medical conditions            antiseizure drugs called anticonvulsants. Doses may
                                                                                                                                   medical check-up is recommended.
other than Epilepsy that can cause seizures. These include:           have to be taken up to four times a day, and people with
                                                                      Epilepsy therefore usually carry medication with them.          Periods of blackout or confused memory.
  Diabetes             poisoning               brain infections       To miss a scheduled dose is to risk a seizure.
                                                                                                                                      Occasional “fainting spells” in which bladder or bowel
  hypoglycemia         heat exhaustion         high fever             Many medications are used in the treatment of Epilepsy.         control is lost, followed by extreme fatigue.
  pregnancy            head injury                                    More than one drug may be prescribed. Among
                                                                      them phenobarbital, Ativan (lorazepan), Klonopin                Episodes of blank staring in children; brief periods
                                                                      (clonazepam), Tranxene (clorazepate) and Valium                 when there’s no response to questions or instructions.
When seizures are continuous or any of these conditions
                                                                      (diazepam).                                                     Sudden falls in a child for no apparent reason.
exist, immediate medical attention is necessary.
                                                                      If a law enforcement officer has any doubts about the           Episodes of blinking or chewing at
The following are some suggestions to help people with Epilepsy       legality of a person’s possession of medication, the            inappropriate times.
avoid unnecessary trips to the emergency room and help one de-        physician who prescribed the drug, or the pharmacy
cide whether or not to call an ambulance. One should not rely on
                                                                                                                                      A convulsion, with or without fever.
                                                                      that dispensed it, should be contacted without delay.
this general information as individual cases may vary, therefore a    Depriving a person with Epilepsy of access to her               Clusters of swift jerking movements in babies.
physician should always be consulted in all emergencies.              medication may put her health and life at risk.
No Need to Call An Ambulance                                          When medication is taken away, for even as little as
                                                                      several hours, the following may happen:
  If medical I.D. jewelry or card says “Epilepsy,” and
  If the seizure ends in under five minutes, and                         A convulsive seizure with subsequent injury due to
  If consciousness returns without further incident, and                 falling on cement floors, or in a confined area.
  If there are no signs of injury, physical distress, or pregnancy.      A series of convulsive seizures called status
                                                                         epilepticus, in which the convulsions continue
An Ambulance Should Be Called                                            non-stop, or are followed by coma or a subsequent
                                                                         series of seizures. These are life threatening, and the
  If the seizure has happened in water.                                  mortality risk is high unless prompt treatment at
  If there’s no medical I.D., and no way of knowing                      a properly equipped medical facility is available.
  whether the seizure is caused by Epilepsy.                             Episodes of automatic behavior, known as complex
  If the person is pregnant, injured, or diabetic.                       partial seizures, in which the person, unaware of
  If the seizure continues for more than five minutes.                   where he is or what his circumstances are, injures
                                                                         himself in unconscious efforts to escape, or is injured
  If a second seizure starts shortly after the first has ended.          in struggles with law enforcement personnel. A
                                                                                                                                                                                                                    in collaboration with

  If consciousness does not start to return after the                    person having this type of seizure is on automatic
  shaking has stopped.                                                   pilot so far as his actions are concerned. Efforts to
If the ambulance arrives after consciousness has returned,               restrain can produce a fighting reaction which he
the person should be asked whether the seizure was                       cannot control.
                                                                                                                                                                                                                    Dr. Ruth Nass
associated with Epilepsy and whether emergency room
care is wanted.
The purpose of this informational brochure is to offer general                        Network determined that 1 in 150 children are                     The risk of Epilepsy is low, about 2% by 5 years and 10%        First Aid for Seizures in
information on Autism and Epilepsy and the co-condition as                            diagnosed with an Autism in the United States. In                 by 10 years, for those with Autism who do not have intel-
well as the types of seizures and basic first aid recommended by                      some states the diagnosis is more prevalent.                      lectual and developmental disabilities or Cerebral Palsy.       Special Circumstances
the Epilepsy Foundation.* One should not rely on this general
information as individual cases may vary. It is recommended                           Autism is a lifespan challenge and most individuals,              Individuals with both Autism and Epilepsy have a                Although the fold-out chart inside this brochure gives
that one’s physician should always be consulted on all                                including those with Asperger Syndrome, will require              more challenged developmental trajectory than those             information on basic first aid for a generalized tonic clonic
                                                                                      some sort of support and services throughout their lifetime.      with either Autism or Epilepsy alone.                           (convulsive) seizure, there are some special circumstances in
information provided here as a public service.
                                                                                                                                                                                                                        which additional steps should be taken. One should not rely on
* This information is taken from Seizure Recognition and First Aid, a publication     Individuals with Autism are capable of participating              Individuals with Autism and severe intellectual and             this general information as individual cases may vary, therefore a
of the Epilepsy Foundation.                                                                                                                             developmental disabilities have a risk of acquiring Epilepsy
                                                                                      in community life and can live, work and recreate in                                                                              physician should always be consulted on all first aid procedures.
                                                                                      community settings with the proper support.                       of 5% at 1 year, 15% at 5 years, and 25% at 10 years.
Facts About Autism                                                                                                                                      Individuals with Autism and both intellectual and de-
                                                                                                                                                                                                                        A seizure in water
                                                                                      Individuals with Autism have diverse talents and
                                                                                      abilities and can contribute to society in suitable and           velopmental disabilities and Cerebral Palsy have a risk         If a seizure occurs in water, the person should be
    Autism affects each individual in a different manner                                                                                                of acquiring Epilepsy of 20% at 1 year, 35% at 5 years,         supported in the water with the head tilted so his face
                                                                                      sustainable endeavors.
    but is generally characterized by impairments in social                                                                                             and 65% at 10 years.                                            and head stay above the surface. He should be removed
    interactions and communication skills. In some people,                                                                                                                                                              from the water as quickly as possible with the head in
                                                                                                                                                        Epilepsy persists in the majority of patients into adult
    Autism also affects cognitive, emotional and behavioral                         Facts About Epilepsy                                                life with remission in only 15% of adults with Autism           this position. Once on dry land, he should be examined
    functioning. People with Asperger Syndrome (also                                                                                                                                                                    and, if he is not breathing, artificial respiration should
                                                                                                                                                        and Epilepsy.
    know as high functioning Autism) may have superior                                Epilepsy is defined as a tendency toward recurrent                                                                                be begun at once. Anyone who has a seizure in water
    skills and intelligence.                                                          seizures unprovoked by any systematic or acute                    Epilepsy and Autism may reflect the same underlying             should be taken to an emergency room for a careful
                                                                                      neurologic insults.                                               brain abnormality and there are many disorders such             medical checkup, even if he appears to be fully recovered
    Autism is four times more prevalent in boys than girls.
                                                                                                                                                        as Fragile X, Tuberous Sclerosis and Down Syndrome
                                                                                      A seizure is the manifestation of abnormal electrical                                                                             afterwards. Heart or lung damage from ingestion of water
    No one is sure what causes Autism but studies of twins                                                                                              where Autism and Epilepsy may co-occur on this basis.
                                                                                      activity in the brain.                                                                                                            is a possible hazard in such cases.
    reveal that it is potentially a genetically based condition.
    In identical twins there is an 80-90% chance that each                            The highest incidence of a first seizure occurs in                                                                                A seizure in an airplane
    will have Autism and in non-identical twins there is                              individuals under 20 years old.
                                                                                                                                                     Types of Seizures
    a 3-10% chance that both will develop Autism. The                                                                                                                                                                   If the plane is not filled, and if the seat arms can be folded
                                                                                      In 2008, the CDC reported that 2.7 million Americans           Seizure disorders take several forms, depending on where in        up, passengers to the left and/or right of the affected
    chance that siblings will both be affected by Autism is
                                                                                      have Epilepsy and that Epilepsy affects 1 in 100 adults.       the brain the malfunction takes place and how much of the          person may be reassigned to other seats, so that the person
    also approximately 3-10%.
                                                                                      There are different types of seizures that are manifested      total brain area is involved.                                      having the seizure can be helped to lie across two or more
    Early signs of Autism may include lack of social interaction,                                                                                                                                                       seats with head and body turned on one side.
                                                                                      by a variety of symptoms.                                      Generalized tonic clonic seizure: These are the ones
    communication, and inappropriate behavior. Autism’s
    early signs may be detected in infants as young as 6-18                           Seizures can be diagnosed by electroencephalogram              which most people generally think of when they hear the            Once consciousness has fully returned, the person can be
    months and is often reported by parents who are concerned                         known as an “EEG” which is a recording of electrical           word “Epilepsy.”                                                   helped into a resting position in a single reclining seat.
    that their child fixates on objects, does not respond to                          activity in the brain.                                         In this type of seizure the person undergoes convulsions           If there are no empty seats, the seat in which the person
    their name, avoids eye contact and engages in repetitive                          Medications are available to help individuals control          which usually last from two to five minutes, with complete         is sitting can be reclined, and, once the rigidity phase has
    movements such as rocking or arm flapping. Parents who                                                                                           loss of consciousness and muscle spasms.                           passed, he can be turned gently while in the seat so that
                                                                                      seizures and in some cases may be reduced or
    notice such signs or are concerned that their child is not                                                                                       Absence seizure: Takes the form of a blank stare lasting           he is leaning towards one side.
                                                                                      discontinued as a person ages.
    meeting developmental milestones, should contact their                                                                                           only a few seconds.
    pediatrician and arrange for a developmental screening.                           Individuals with Epilepsy can lead full and productive                                                                            Pillows or blankets can be arranged so that the head
                                                                                      lives with proper treatment and monitoring.                    Partial seizure: Produces involuntary movements of arm or          doesn’t hit unpadded areas of the plane. However, care
    Scientists agree that early intervention services can                                                                                            leg, distorted sensations, or a period of automatic movement       should be taken that the angle at which the person is
    increase chances for a child’s positive prognosis.                                                                                               in which awareness is blurred or completely absent.                sitting is such that his airway stays clear and breathing
    Children with Autism can benefit from known effective                           Epilepsy and Autism: The Co-Condition                                                                                               is unobstructed.
    treatments such as applied behavior analysis (ABA),                                                                                              Since these seizure disorders are so different in their effects,
    occupational, speech and physical therapy. Other                                                                                                 they require different kinds of action from the public. Some       A seizure on a bus
                                                                                      As many as one-third of individuals with Autism also           require no action at all. The fold-out section of this brochure
    treatments touted on the internet and in the media                                                                                                                                                                  Ease the person across a double or triple seat. Turn him
                                                                                      have Epilepsy.                                                 describes seizures in detail, and how to handle each type. It
    may not be backed by science and should be cautiously                                                                                                                                                               on his side, and follow the same steps as indicated above.
                                                                                      Two peaks of onset: infancy and adolescence.                   has been produced in this form to encourage posting on staff
    pursued as they may cause harmful side effects.                                                                                                                                                                     If he wishes to do so, there is no reason why a person who
                                                                                                                                                     bulletin boards or other places where it can be easily seen, for
    In 2007, the Center for Control and Prevention’s                                                                                                 example, by caregivers, first-responders, and by those who         has fully recovered from a seizure cannot stay on the bus
    Autism and Developmental Disabilities Monitoring                                                                                                 work with individuals who have Autism and/or Epilepsy.             until he arrives at his destination.
    Autism, Epilepsy & Seizures:                                                                                                                                           in collaboration with
                                                                                                                                                                                                                   Dr. Ruth Nass
    How to Recognize the Signs and Basic First Aid When You Do                                                                    609-392-4900
                                                                                                                                This information is taken from Seizure Recognition and First Aid, a publication of the Epilepsy Foundation.

 SEIZURE TYPE                    WHAT IT LOOKS LIKE                                 WHAT IT IS NOT                              WHAT TO DO                                                                 WHAT NOT TO DO

Generalized                  Sudden cry, fall, rigidity, followed by muscle
                             jerks, shallow breathing or temporarily
                                                                                    Heart attack.
                                                                                                                    Look for medical identification.
                                                                                                                    Protect from nearby hazards.
                                                                                                                                                                                                       Don’t put anything in the mouth.
                                                                                                                                                                                                       Don’t try to hold tongue. It can’t be
                             suspended breathing, bluish skin, possible loss of
Tonic Clonic                 bladder or bowel control, usually lasts a couple
                             of minutes. Normal breathing then starts again.
                                                                                                                    Loosen ties or shirt collars.                                                      swallowed.
                                                                                                                                                                                                       Don’t try to give liquids during or
(Also called Grand Mal)      There may be some confusion and/or fatigue,
                                                                                                                    Protect head from injury.
                                                                                                                                                                                                       just after seizure.
                             followed by return to full consciousness.                                              Turn on side to keep airway clear unless injury
                                                                                                                    exists. Reassure as consciousness returns.                                         Don’t use artificial respiration unless
                                                                                                                                                                                                       breathing is absent after muscle
                                                                                                                    If single seizure lasted less than 5 minutes, ask if                               jerks subside.
                                                                                                                    hospital evaluation wanted.
                                                                                                                                                                                                       Don’t restrain.
                                                                                                                    If multiple seizures, or if one seizure lasts longer
                                                                                                                    than 5 minutes, call an ambulance.
                                                                                                                    If person is pregnant, injured, or diabetic, call for
                                                                                                                    aid at once.

Absence                      A blank stare, beginning and ending abruptly,
                             lasting only a few seconds, most common in
                                                                                    Lack of attention.
                                                                                                                    No first aid necessary, but if this is the first
                                                                                                                    observation of a seizure, medical evaluation is
(Also called Petit Mal)      children. May be accompanied by rapid blinking,
                                                                                    Deliberately ignoring adult
                             some chewing movements of the mouth, Child
                             or adult is unaware of what’s going on during          instructions.
                             the seizure, but quickly returns to full awareness
                             once it has stopped. May result in learning
                             difficulties if not recognized and treated.

Simple Partial               Jerking may begin in one area of body, arm, leg,
                             or face. Can’t be stopped, but patient stays awake
                                                                                    Acting out, bizarre behavior.
                                                                                                                    No first aid necessary unless seizure becomes
                                                                                                                    convulsive, then first aid as above.
                             and aware. Jerking may proceed from one area of                                        No immediate action needed other than
                             the body to another, and sometimes spreads to          Mental illness.
                                                                                                                    reassurance and emotional support.
                             become a generalized convulsive seizure.               Psychosomatic illness.
                                                                                                                    Medical evaluation is recommended.
                                                                                    Parapsychological or
                                                                                    mystical experience.

Complex Partial              Usually starts with blank stare, followed by
                             chewing, followed by random activity. Person
                                                                                    Intoxication on drugs.
                                                                                                                    Speak calmly and reassuringly to patient and
                                                                                                                                                                                                       Don’t grab hold unless sudden
                                                                                                                                                                                                       danger (such as a cliff edge or an
(Also called Psychomotor     appears unaware of surroundings, may seem dazed
                                                                                    Mental illness.                 Guide gently away from obvious hazards.                                            approaching car) threatens.
                             and mumble. Unresponsive. Actions clumsy, not
or Temporal Lobe)            directed. May pick at clothing, pick up objects,       Disorderly conduct.             Stay with person until completely aware of                                         Don’t try to restrain.
                             try to take clothes off. May run, appear afraid.                                       environment.                                                                       Don’t shout.
                             May struggle or flail at restraint. Once pattern                                       Offer to help getting home.                                                        Don’t expect verbal instructions to
                             established, same set of actions usually occur                                                                                                                            be obeyed.
                             with each seizure. Lasts a few minutes, but post-
                             seizure confusion can last substantially longer. No
                             memory of what happened during seizure period.

Atonic Seizures              A child or adult suddenly collapses and falls,
                             After 10 seconds to a minute he recovers, regains
                                                                                    Normal childhood “stage.”
                                                                                                                    No first aid needed, unless the person was hurt
                                                                                                                    upon falling.
(Also called Drop Attacks)   consciousness, and can stand and walk again.
                                                                                    In a child, lack of good        Medical evaluation is recommended.
                                                                                    walking skills.
                                                                                    In an adult, drunkenness,
                                                                                    acute illness.

Myoclonic                    Sudden brief, massive muscle jerks that may
                             involve the whole body or parts of the body. May
                                                                                    Poor coordination.
                                                                                                                    No first aid needed, but medical evaluation is
                             cause person to spill what they were holding or
Seizures                     fall off a chair.

Infantile                    These are clusters of quick, sudden movements
                             that start between 3 months and two years. If a
                                                                                    Normal movements of
                                                                                    the baby.
                                                                                                                    No first aid needed, but medical evaluation is
                             child is sitting up, the head will fall forward, and
Spasms                       the arms will flex forward. If lying down, the
                             knees will be drawn up, with arms and bead flexed

                             forward as if the baby is reaching for support.